Cerebral Palsy (CP), the most common movement disorder in children, affects approximately 750,000 people in the United States. The disorder results from a non-progressive brain injury or malformation that occurs while a child’s brain is still developing, and can impair muscle tone, posture and body movements that effect activity and participation such as walking.
Weight shifting is one of the key components for a natural gait pattern but many children with CP have an impaired weight shift capacity, which may be related to their functional deficits in walking. While several robotic gait training systems have been developed with the intention to improve walking function in children with CP, there has been insufficient evidence to prove their effectiveness — until now.
A new study led by Ming Wu, PhD and research scientist, and his team at the Shirley Ryan AbilityLab, is the first to provide direct evidence to indicate that improving weight shifting capacity of children with CP may improve their overall walking function.
These results are very exciting and have already been translated into clinical practice at the Shirley Ryan AbilityLab with the addition of robotics. With widespread adoption of this intervention paradigm, walking function in children and adults with CP has the potential to be improved.Deborah J. Gaebler-Spira
As part of the study, 23 children with CP were randomly assigned to a robotic training or a conventional treadmill training group. Each child was trained three times a week for six weeks on their assigned device. For those children in the robotic training group, robotic assistance force was applied to the pelvis and legs during treadmill walking to facilitate weight shift and leg swing. Walking function of children in both groups was assessed immediately before and after the six weeks of training, as well as eight weeks following the end of training.
The results were compelling: researchers found significant increases in walking speed and endurance for children in the robotic training group, which was assessed using a six-minute walking distance test. No significant changes were observed among children in the treadmill training only group.
“These results are very exciting and have already been translated into clinical practice at the Shirley Ryan AbilityLab with the addition of robotics,” noted Deborah J. Gaebler-Spira, MD, director of the hospital’s Cerebral Palsy Program. “With widespread adoption of this intervention paradigm, walking function in children and adults with CP has the potential to be improved.”
Effects of the Integration of Dynamic Weight Shifting Training Into Treadmill Training on Walking Function of Children with Cerebral Palsy: A Randomized Controlled Study. Wu M, Kim J, Arora P, Gaebler-Spira DJ, Zhang Y. Am J Phys Med Rehabil. 2017 Jun 21.